FACT: Effectively dealing with the AIDS pandemic is a complex process that involves addressing a host of issues.

Certainly, ensuring that all people living with HIV/AIDS—commonly referred to as PLHA—have access to quality health care and appropriate therapies is crucial in the fight against the pandemic, but it is just one among several necessary ways to deal with the problem of global AIDS. No less significant is battling ignorance, stigma and discrimination—also among the greatest barriers to preventing infections, providing effective treatment and reducing the impact of HIV/AIDS for millions around the world.

In many respects, the epidemic of ignorance, stigma and discrimination is as serious as the fast-moving spread of HIV/AIDS itself. Availability of a new vaccine to prevent HIV or of cheaper anti-retroviral drugs can certainly provide relief and sustain the lives of millions. But tackling the epidemic is not merely a medical challenge. It requires dramatic changes in people’s mindsets, attitudes and behavior. No amount of medical or technical intervention can single-handedly solve the pandemic until societies address the many myths surrounding the virus as well.

Examples of HIV/AIDS-related myths are countless. In India, many people believe that people can contract HIV from mosquito bites or by sharing food with a person who is infected. In Cambodia, it is sometimes thought that a healthy looking person cannot have HIV/AIDS. In many countries, others are convinced that a sure-fire cure for AIDS is having intercourse with a virgin. These examples—and many more like them—are not only unfounded, they are also dangerous.

Such myths are the fuel for the discrimination that results in denying PLHA from receiving the care they need. Throughout the world, PLHA face stigma within their family and the community. In such cases, they are viewed as irresponsible, promiscuous or immoral, and are shunned from their homes or forced into isolation. It is also not uncommon for members of health care facilities and law enforcement to discriminate against infected or at-risk people. An illustration of this point is shown by the results of a survey conducted in Nigeria, which revealed that 1 in 10 healthcare professionals admitted to having refused care for an HIV/AIDS patient or to denying hospital admission to PLHA.

Misinformation from a range of outlets—media, government and even close communities of friends and family—reinforce or generate fear and judgment against PLHA, and often those at high risk of infection. Discriminatory behavior is aggravated when governments introduce insensitive policies such as compulsory screening and testing, mandatory notification of AIDS cases, restrictions on the right to anonymity, and in some instances, isolation and confinement of infected persons, to the point of even restricting their travel and migration.

The most profound positive impact, however, has occurred when there is active involvement of people living with, or affected by, HIV/AIDS in initiatives to combat the epidemic. According to a study conducted in Burkino Faso, Ecuador, Zambia and India by the Population Council, an international nonprofit that conducts research in global health issues, and the International AIDS Alliance, involving PLHA in health care service delivery can both help fight stigma and discrimination, and have a therapeutic effect on PLHA themselves. Participants in the study reported to have improved mental and physical health because of better access to information, and in some cases, medical care and treatment.

Understanding cultural contexts is also extremely important when thinking of effective ways to tackle stigma and end discrimination. Interventions must involve massive public education, using well-known public figures, especially state officials, to denounce discrimination, as well as the re-examination of policies to ensure fair treatment of at-risk populations and PLHA. Many societies across the world have devised innovative ways of dealing with stigma and discrimination, including leadership training, media advocacy, dissemination of information, and use of effective legislation.

References: Horizons Program, “HIV/AIDS-related Stigma and Discrimination: A conceptual framework and an Agenda for Action” Richard Parker and Peter Aggleton with Kathy Attawell, Julie Pulewitz and Lisanne Brown, The Population Council Inc., New York, 2002.